Table IX.
Net cost-savings and incremental cost–benefit ratios for every dollar invested in each clinical best care practice (CBP) as it related to its target in a healthcare-associated infection (HCAI) prevention and control programme
| Authors | Chun et al., 2016 | Chowers et al., 2015 | Bessesen et al., 2013 | Hassan et al., 2007 | Montecalvo et al., 2001 | van Rijen et al., 2009 |
Wassenberg et al., 2011 | Wassenberg et al., 2011 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| CBPs | Hand hygiene | Prevention and control programme (screening with nasal swab + additional contact isolation precautions + basic precautions with gloves and gowns + eradication treatment + nasal mupirocin and chlorhexidine body wash) | Two additional contact precautions (contact precautions as defined by CDC + contact precaution only use of gloves) | Screening using PCR | Prevention and control program (screening + basic precautions with gloves and gowns + patient education by nurses + antimicrobial control using nurse monitoring) | Search and destroy (screening + additional precaution isolation + basic precautions with gowns, gloves, masks) + cleaning and sanitation + contact tracing + treatment of carriers + closure of wards + outbreak situation) | Different MRSA screening regimes using rapid diagnostic testing (using ‘nares only’ chromogenic agar, IDI, GeneXpert) + additional precaution isolation | Different MRSA screening regimes using rapid diagnostic testing (chromogenic agar, IDI, GeneXpert, all body sites tested) + additional precaution isolation | ||
| Price date | 2005 | 2011 | 2006 | 2005 | 1995 | 2006 | 2008 | 2008 | ||
| Currency | $US | $US | $US | £ | $US | € | € | € | ||
| Exchange rate | 1.21 | 1.00 | 1.13 | 1.50 | 1.37 | 1.42 | 1.67 | 1.67 | ||
| Discount rate 0% | Net cost savings (2019 $CAD) | Min | 29,167 | 168,027 | 25.37 | 33.32 | ||||
| Mean | 851,565 | 199,600 | 576,000 | 259,365 | 606,845 | 51.49 | 159.94 | |||
| Max | 207,478 | 430,895 | 75.77 | 209.47 | ||||||
| IBCR (2019 $CAD) | Min | 1.14 | 1.91 | 2.49 | ||||||
| Mean | 6.15 | 1.96 | 3.29 | 2.82 | ||||||
| Max | 10.60 | 2.21 | 5.77 | |||||||
| Discount rate 3% | Net cost savings (2019 $CAD) | Min | 42,833 | 341,565 | 35.11/isolation day saved | 46.12 | ||||
| Mean | 1,288,068 | 252,847 | 871,251 | 527,236 | 891,173 | 71.27 | 221.39 | |||
| Max | 304,688 | 875,921 | 104.88 | 289.95 | ||||||
| IBCR (2019 $CAD) | Min | 1.72 | 2.89 | 5.07 | ||||||
| Mean | 9.30 | 2.48 | 6.68 | 4.13 | ||||||
| Max | 16.03 | 3.34 | 11.72 | |||||||
| Discount rate 5% | Net cost savings (2019 $CAD) | Min | 54,999 | 541,906 | 43.39 | 56.98 | ||||
| Mean | 1,686,040 | 294,900 | 1,140,440 | 836,480 | 1,144,297 | 88.06 | 273.54 | |||
| Max | 391,231 | 1,389,679 | 129.59 | 358.26 | ||||||
| IBCR (2019 $CAD) | Min | 2.25 | 3.79 | 8.04 | ||||||
| Mean | 12.17 | 2.89 | 10.60 | 5.31 | ||||||
| Max | 20.99 | 4.37 | 18.60 | |||||||
| Discount rate 8% | Net cost savings (2019 $CAD) | Min | 79,324 | 1,065,494 | 59.15 | 77.68 | ||||
| Mean | 2,501,211 | 369,445 | 1,691,823 | 1,644,684 | 1,650,391 | 120.05 | 372.91 | |||
| Max | 564,262 | 2,732,383 | 176.66 | 488.40 | ||||||
| IBCR (2019 $CAD) | Min | 3.34 | 5.62 | 15.81 | ||||||
| Mean | 18.05 | 3.63 | 20.85 | 7.66 | ||||||
| Max | 31.13 | 6.48 | 36.57 | |||||||
CDC, Centers for Disease Control; IBCR, incremental benefit cost ratio; MRSA, methicillin-resistant Staphylococcus aureus; PCR, polymerase chain reaction.